A Return to A Sanctity of Life Ethic in Medical Care

John L. Rustin speaks with Dr. Marty McCaffrey, a clinical professor in neonatal and perinatal medicine at UNC Chapel Hill, and Director of the Perinatal Quality Collaborative of North Carolina. They discuss the current trends in regards to a sanctity of life ethic in medical care.

Family Policy MattersTranscript: A Return to A Sanctity of Life Ethic in Medical Care

JOHN RUSTIN: This week we’re pleased to bring you part two of a discussion with Dr. Marty McCaffrey, a clinical professor in neonatal and perinatal medicine at UNC Chapel Hill and one of North Carolina’s leading medical voices calling for a return to a sanctity of life ethic in medical care. Director of the Perinatal Quality Collaborative of North Carolina.

Dr. McCaffrey, welcome back to Family Policy Matters, it’s great to have you on the show again.

MARTY MCCAFFREY: John, thanks very much for having me, it’s wonderful, it’s great to be here.

JOHN RUSTIN: Dr. McCaffrey, I know that bioethicist Wesley J. Smith has called the Charlie Gard situation a case of “medical aggression.” Do you think that that’s an accurate representation of this situation and others like, or do you think it’s just of kind of being victims of a system that is bankrupt and out of control?

MARTY MCCAFFREY: I think there’re two forces at work here. So I think social engineers at the policy-type level who are not providers living in the trenches with patients like this, or patients not quite this sick, who just have never touched a patient in their lives, are able to sit in cubbyholes or in offices and think about “best policy for the public at large,” without feeling any of the potential impact that comes from what you have to deal with on a very personal level, i.e. the physicians, the nurses, the respiratory therapists, the other providers who are engaged on this care. So I think what happens is that that administrative level, I think there is an aggression that I would not call medical aggression, but I think it’s an aggressive socialism. I think it is an ideology that says, “this is the best system, this is the way to go, but by golly the reality is that we don’t have money to give everything to everybody and so we have to make some serious decisions here.” I think in conjunction with that is also the radical transformation that’s occurred in bioethics. So I think battle that I alluded to earlier, the 60’s, 70’s, maybe into the 80’s, where the Paul Ramseys of the world, the Gilbert Meilaenders of the world have been doing battle with folks like Joseph Fletcher, Peter Singer and Daniel Callahan. I think the postmodern bioethicists really have won that battle in that day. I’m hoping we can get back to a system that will provide real patient-centered bioethical care. And I don’t want to paint bioethicists as monolithic either, I know some good bioethicists who really still respect the sanctity of life, but they are not the majority. And so I think there’s this push-pull that goes on John, between the realities of the finances of an ideology of socialism, but I think there’s also a bioethical mantra that has been engrained in medical education, nursing education, healthcare providers, and now which has really infected the public at large, that is totally unhooked from the sanctity of life, it’s totally relativistic, and is totally steeped in the Georgetown mantra of principles which are: autonomy, beneficence, justice and non-maleficence. Which, in and of themselves are excellent principles, but when unhooked from the sanctity of life, become opportunities to justify outcomes, and certainly people running the socialist systems need to justify outcomes because they don’t have the money to support care for everybody. So what happens is that autonomy and beneficence now become, “Oh well Charlie can’t exercise authority for himself, is parents are overriding his autonomy. Beneficence says, based on the best medical evidence that we have, that he cannot have a productive live, and he’s gonna live a life of suffering, so we will step in under the mantra of current bioethics and say this is the right thing to do.” You know, futile care used to refer to the futility of the care we were rendering because it couldn’t continue life and it was not going to be successful in terms of promoting the physiology of what we define as life; our brain functioning and our heart beating. I mean now the futility of futile care refers to a judgment on the life that we would preserve, because in fact futile care works, we can keep at patient alive. But the question them becomes, “Do you judge their life worth keeping alive?” And I think this is really the tyranny of bioethics at this point, unhooked and relativistic bioethics has free rein to basically develop any type of system that it wants, and justification for any system that it wants based on these principles, which really have no grounding on any foundation which formerly was the sanctity of life.

JOHN RUSTIN: Well Dr. McCaffrey, what kind of hope can you provide to our listeners? Especially those who may be facing a difficult diagnosis or, a young child, an adult parent, or even listeners who may be considering getting in to the medical profession but are concerned about the real loss of a sanctity of human life and human dignity. What kind of words of hope can you provide to them that may be n encouragement.

MARTY MCCAFFREY: I think there is hope, and the battlefield I think is kind of laid out in terms of where you need to go. You need to fight abortion as much as you can, you need to get transparency out for non-invasive pre-natal testing, you need to end dehydrating cognitively impaired people, you need to put an end to assisted suicide, you need to restore hospice to it’s original mission. Let me refer to an area that I have been actively engaged in John, and that we mentioned a lot about the babies with Trisomy 13 and 18, and we also mentioned Down Syndrome, Trisomy 21, for babies who are born alive now with Trisomy 21, those children are now offered all of the same medical opportunities and medical interventions pretty much that any other child is offered. That was not the case even 30 years ago. Even 30-40 years ago there were great disparities in what was being offered in terms of long-term care. There were still recommendations back in the 80s and 90s, that children with Down Syndrome be institutionalized and we have realized now that these are just precious souls who really may be offer us the opportunity to save our humanity if we’re willing to accept them and overcome our own imperfections in looking at them, and accept them as critical parts of our society. I think what you’re seeing with Trisomy 13 and 18 have been turbo-charged compared to what happened with Trisomy 21. Its not been so much on the healthcare providers’ side, you are seeing families and parents being motivated and organized in a way that didn’t exist 30 or 40 years ago, and that’s really through social media. I’m currently working with, a number of us as physicians are doing this, we have found a niche in terms of trying to support and helping these families who are dealing with individuals with a variety of conditions, not just children’s but adults as well, with potentially life-limiting conditions. And that opens up huge opportunities to start working and partnering with families. And a little bit to the sadness of some physicians and some administrators, and policy-type folks who really would rather perpetuate more of a very different type of bioethics. So, I think there is lots of opportunity out there for us to try and organize and get people to really understand how special and important these individuals can be to us. I think it is, I hate to use the term and get overdramatic, but it is a bit of a war. It’s been described by Wesley Smith, and Gilbert Meilaender, and others as a class of ethics in terms of what’s gone on in the bioethical landscape over the last 20 or 30 years. And I think that’s true, and I think there is a very strong postmodern force that is pushed its way along on that battlefield and has the upper hand, but this fight is not over by any means. I think it is vital when we look at these kids and these children and these adults, people who are cognitively impaired, people with Alzheimer’s, these are all sacred lives and I think we all need to realize that there’s sort of an opportunity even if we’re not theistic or Christian, or even have a strong religious foundation, to realize at a minimum we all should develop a sense of “acknowledged dependence” is what people have called it, in terms of how we deal with people, in terms of bioethical situations. None of us is getting out of this life alive John, and we’re all eventually gonna need each other in some way shape or form unless we die a very quick sudden death. But many of us will grow older and we are going to have our share of debilitating challenging medical maladies, and so this is really our opportunity to try and form and reform the bonds which can make us a much stronger and a much better society. And I think the word that get’s lost, and rarely is mentioned, and distressingly to me, in medicine at this point is ‘love.’ I think that’s too personal for some people involved in medicine, and how could you ever bring that up, but I think we have to look at the sanctity of life of our individual patients, and I think most of us as physicians at night lying in bed, we would admit that really we do love our patients. But we have to start valuing their lives and realize that we can’t value some lives more than other lives. I think there is hope and I think there are, when you look at attitudes towards abortion, when you look at the controversies that we face in this country that are raging over assisted suicide, people are pushing back and we, the sanctity of life ethic will not go quietly into the night John. But we do need people willing to come forward and be soldiers in the fight, and I think there are plenty of them out there. I’ve been blessed to work with a number of them in medical schools, and encounter a number of them across the country, and the day is not over yet. But the fight is going to be long, and we have a long ways to go.

JOHN RUSTIN: Now Dr. McCaffrey, before we leave is there a website, or are there a couple of websites that you might direct our listeners to that are particularly interested in this topic, or would like to connect with you or others and explore the research and information that you’ve put together on these topics.

MARTY MCCAFFREY: Yeh, sure, there are some good sites out there. I think when people think of bioethics the go-to place that a lot of people think of is the Hastings Center, and I would say that that’s at best a mixed-bag in terms of the sanctity of human life. Actually Hastings, the founder of that, was Daniel Callahan who is clearly someone who is a bit more in the relativistic side. I think it’s always, I would go there and look at the Hastings Center and look at what the current big names in bioethics are thinking and saying, but then to really try and get an appreciation of the sanctity of life and bioethics, there’s at least two places I would go, one is the Deverber Institute, and then in Charlotte the Charlotte Lozier Institute. The other site that I would recommend is the American Academy, I’ll recommend two, the American Academy of Pro-Life OBGYNs, aaplog.org, this is a group of obstetricians and they allow some neonatologists to go along sometimes as well, who take care of babies that they deliver. It’s actually quite a sizable group of folks who are really very interested in trying to return sanctity of life to the practice of perinatal medicine. And then I would also recommend the American College of Pediatrics website, the ACP. The American Academy of Pediatrics like the American Congress of OBGYN are both very mainstream, fairly relativistic. I agree with a number of things, there’s been some great scientific stuff that comes out there and some great innovation for health for moms and babies, but they are not sanctity of life-focused sites. But the American College of Pediatrics is, as well as the American Academy of Pro-Life OBGYNs.

JOHN RUSTIN: Very good. Well thanks for sharing those. Well with that Dr. Marty McCaffrey I want to thank you so much for being with us on Family Policy Matters. For your tireless efforts not only to provide extraordinary care to some of the smallest and weakest patients, but also to bring attention not only in our state and in our nation, but around the world, to the dignity and value that we all have as members of the human race. Thank you so much for all that you do, and we will continue to pray for your efforts, and pray God’s blessings on you and your family as well.

MARTY MCCAFFREY: Thank you so much John, and thank you for the great work that you guys are doing at North Carolina Family Policy Council. It was a pleasure to be here, I hope to come back some time in the future.

JOHN RUSTIN: Thanks so much. We look forward to having you back again.